
Die Erfindung betrifft ein Verfahren nach dem Oberbegriff des Patentanspruchs 1 und eine elektrochirurgische Vorrichtung nach dem Oberbegriff des Anspruches 7.The invention relates to a method according to the preamble of claim 1 and an electrosurgical device according to the preamble of claim 7.
Bei stark durchblutetem Biogewebe besteht häufig das Erfordernis, unter Verwendung der Hochfrequenz-Chirurgie Gewebeoberflächen berührungslos und gleichmäßig zu koagulieren. Konventionell wird dies mit der sogenannten Sprüh-Koagulation bzw. Spray-Koagulation bei hohen Hochfrequenzspannungen im Bereich von Kilovolt bewerkstelligt. Ein Nachteil dieser konventionellen Technik ist die Unregelmäßigkeit des Lichtbogenbereichs und die Gefahr, die Gewebeoberfläche zu karbonisieren.In the case of highly perfused organic tissue, there is often the need to use non-contact and uniform coagulation of tissue surfaces using high-frequency surgery. Conventionally, this is done with the so-called spray coagulation or spray coagulation at high high-frequency voltages in the range of kilovolts. A disadvantage of this conventional technique is the irregularity of the arc area and the risk of carbonizing the tissue surface.
Eine Verbesserung wurde dadurch erzielt, daß durch Einblasen eines Edelgases z. B. von Argon ein Ionisierungspfad geschaffen wurde, der zur Verbesserung der Gleichmäßigkeit bei der Koagulation von Gewebeoberflächen beitrug. Ein derartiges Verfahren ist z. B. in der EP 0 353 177 A1 beschrieben. Nachteil dieses Verfahrens ist die Verwendung des recht teuren und in Kliniken häufig nicht verfügbaren Edelgases.An improvement was achieved in that by blowing a noble gas z. B. Argon created an ionization path that helped improve uniformity in the coagulation of tissue surfaces. Such a method is e.g. B. described in EP 0 353 177 A1. The disadvantage of this method is the use of the very expensive noble gas, which is often not available in clinics.
Das Ziel der vorliegenden Erfindung besteht darin, ein Verfahren und eine Vorrichtung der eingangs genannten Gattung zu schaffen, mittels denen ein Ionisierungspfad im Bereich der aktiven Elektrode mit einfacheren Maßnahmen zur Verfügung gestellt wird.The aim of the present invention is to provide a method and a device of the type mentioned at the beginning, by means of which an ionization path in the area of the active electrode is made available with simpler measures.
Zur Lösung dieser Aufgabe sind die Merkmale der Patentansprüche 1 und 7 vorgesehen.To achieve this object, the features of claims 1 and 7 are provided.
Der Erfindung liegt der Grundgedanke zugrunde, daß ein Ionisierungspfad auch mit anderen Medien als Edelgasen möglich ist. Als vorteilhaft hat sich hierbei die Erzeugung eines Aerosols aus einer niederprozentigen Kochsalzlösung herausgestellt. Die Kombination von Hochfrequenz an der aktiven Elektrode einer elektro-chirurgischen Vorrichtung mit einer NaCl-Lösung ist zwar bekannt, doch wurde diese bisher nur verwendet, um ein Ankleben der Elektroden am Biogewebe zu verhindern.The invention is based on the basic idea that an ionization path is also possible with media other than noble gases. The production of an aerosol from a low-percentage saline solution has proven to be advantageous. The combination of high frequency on the active electrode of an electrosurgical device with a NaCl solution is known, but has so far been used only to prevent the electrodes from sticking to the biological tissue.
Erfindungsgemäß wird dem gegenüber ein Aerosol mit einem gewissen Spüldruck von z. B. 3,5 bar um die Elektrode herumgespült bzw. herumgeblasen, wodurch ein Ionisierungskegel mit definierter Dimensionierung entsteht.According to the invention, an aerosol with a certain flushing pressure of e.g. B. 3.5 bar around the electrode or blown around, creating an ionization cone with defined dimensions.
Als positive Effekte des erfindungsgemäßen Verfahrens ergeben sich die Verwendung von verfügbaren Medien, z. B. destilliertem Wasser, CO2, NaCl-Lösung, eine gleichmäßige Koagulation des Biogewebes in einer festumgrenzten Fläche, eine geringe Gefahr einer Karbonisierung, eine Kühlung der Elektrode, keine, sonst übliche Rauchbildung und keinerlei Geruchsbildung durch Verbrennen von Gewebe.The use of available media, eg. B. distilled water, CO2 , NaCl solution, a uniform coagulation of the biological tissue in a fixed area, a low risk of carbonization, cooling of the electrode, no, otherwise usual smoke formation and no odor formation by burning tissue.
Vorteilhafte Ausführungen des erfindungsgemäßen Verfahrens sind durch die Ansprüche 2 bis 6 und vorteilhafte Ausführungsformen der erfindungsgemäßen Vorrichtung durch die Ansprüche 8 bis 10 gekennzeichnet.Advantageous embodiments of the method according to the invention are characterized by claims 2 to 6 and advantageous embodiments of the device according to the invention by claims 8 to 10.
Die Erfindung wird im folgenden beispielsweise anhand der Zeichnung beschrieben; in dieser zeigt
In einem von der Hand des Benutzers ergreifbaren hohlzylinderförmigen Instrumentenkörper 11 ist koaxial eine hochfrequenz-chirurgische Schneidelektrode 12 angeordnet, die gegenüber dem distalen offenen Ende 13 des rohrförmigen Instrumentenkörpers 11 ein Stück zurückversetzt ist und mit einer Zuleitung 12' verbunden ist, die sich - von einer Isolierung 14 umgeben - mit allseitigem Abstand von der Innenwand des rohrförmigen Instrumentenkörpers 11 nach hinten erstreckt, wo im Bereich des proximalen Endes seitlich ein Hochfrequenzanschluß 15 vorgesehen ist, an den eine geeignete Hochfrequenzspannung, die von einem nicht dargestellten Hochfrequenzgenerator erzeugt wird, anlegbar ist. Die zugehörige Neutralelektrode ist an geeigneter Stelle des Patientenkörpers angeordnet. Der distale Bereich des im übrigen aus Metall bestehenden Instrumentenkörpers 11 ist aus einem isolierenden Material 11' hergestellt, welches sich nach hinten bis über die Isolierung 14 der Zuleitung 12' erstreckt.In a hollow cylindrical instrument body 11 which can be grasped by the hand of the user, a high-frequency surgical cutting electrode 12 is arranged coaxially, which is set back a little in relation to the distal open end 13 of the tubular instrument body 11 and is connected to a feed line 12 'which - from one
Die Zuleitung 12' mit der Isolierung 14 wird durch geeignete Halterungen 16 vorzugsweise koaxial innerhalb des Instrumentenkörpers 11 gehalten. Die einzelnen Halterungen 16 sind jeweils über den Umfang um die Isolierung 14 herum mit solchem Abstand angeordnet, daß dazwischen in axialer Richtung ein ausreichend dimensionierter Strömungsdurchgang vorliegt.The supply line 12 ′ with the
Am proximalen Ende des Instrumentenkörpers 11 sind seitlich bzw. axial zwei Zufuhrrohre 17, 18 in das Innere des Instrumentenkörpers 11 hineingeführt. An das Rohr 17 wird eine Leitung angeschlossen, mittels derer beispielsweise eine 0,9 %-ige Kochsalzlösung zugeführt wird. Das axial eingeführte Rohr 18 ist an einen Druckluftanschluß angelegt, so daß es mit Druckluft als Trägergas beaufschlagt werden kann.At the proximal end of the instrument body 11, two
Innerhalb des Hohlraumes 19 des Instrumentenkörpers 11 weisen die Rohre 17, 18 Öffnungen 20, 21 auf, durch welche die Kochsalzlösung bzw. die Luft so in den Innenraum 19 hineingedrückt werden, daß es zu einer Zerstäubung der Kochsalzlösung kommt, d. h. zur Bildung eines Aerosols 20, welches aufgrund des Druckaufbaus insbesondere durch das Rohr 18 in Richtung des Pfeiles durch den Instrumentenkörper 11 zum distalen Ende 13 hin strömt und dort als kegelförmig erweiterndes Aerosolbündel bzw. Aerosolstrahl 22' austritt, welches bzw. welcher somit die Spitze der Schneidelektrode 12 und das von dieser zu koagulierende Biogewebe umgibt. Durch die hohe Spannung der Schneidelektrode 12 wird das Aerosol ionisiert und somit eine ionisierte Strecke zwischen Schneidelektrode 12 und Biogewebe gebildet, auf der sich dann ein besonders gleichmäßiger und damit auch besonders gut lokalisierbarer Lichtbogen ausbildet.Inside the
Das Druckluft-Zufuhrrohr 18 ist derart weit axial in das Innere des Instrumentenkörpers 11 hineingeführt, daß seine Austrittsdüse 20 sich unmittelbar oberhalb und etwas hinter der quer verlaufenden Austrittsdüse 21 des Flüssigkeits-Zufuhrrohres 17 befindet. Auf diese Weise saugt die über die Austrittsdüse 21 strömende Luft Flüssigkeit aus dem Rohr 17 an und zerstäubt sie gleichzeitig zur Bildung des Aerosols 22.The compressed
Statt der durch die Rohre 17, 18 gebildeten Zerstäubungsvorrichtung könnte auch ein Ultraschallvernebler am bzw. im Instrumentenkörper 11 oder in einem Abstand von diesem vorgesehen sein. Im letzteren Fall wäre der Ultraschallvernebler über einen Aerosol-Zuleitungsschlauch mit dem Inneren des Instrumentenkörpers 11 zu verbinden.Instead of the atomizing device formed by the
| Application Number | Priority Date | Filing Date | Title | 
|---|---|---|---|
| DE1995116238DE19516238A1 (en) | 1995-05-03 | 1995-05-03 | Method and device for generating an arc in biological tissue using high-frequency surgical means | 
| DE19516238 | 1995-05-03 | 
| Publication Number | Publication Date | 
|---|---|
| EP0740926A2true EP0740926A2 (en) | 1996-11-06 | 
| EP0740926A3 EP0740926A3 (en) | 1999-02-17 | 
| Application Number | Title | Priority Date | Filing Date | 
|---|---|---|---|
| EP96105805AWithdrawnEP0740926A3 (en) | 1995-05-03 | 1996-04-12 | Arc generating electrosurgical instrument | 
| Country | Link | 
|---|---|
| EP (1) | EP0740926A3 (en) | 
| DE (1) | DE19516238A1 (en) | 
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